CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Dundy County Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $2,072
Cash Discount Price: $2,710
vs. Medicare Baseline: 1.69x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Dundy County Hospital is $2,072. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,710. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.69x the Medicare baseline. Located in P O Box 626, 1313 North Cheyenne St, Benkelman, NE.

Cash / Self-Pay

$2,710

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,072

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$1,222.56

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $1,222.56 (100%)

Cash / Self-Pay: $2,710 (222%)

Insurance Median: $2,072 (169%)

Cash: $2,710 (222% of Medicare)

Ins. Median: $2,072 (169% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $1,222.56 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Molina	$1,425 - $1,586	117%
UnitedHealthcare	$1,425 - $2,062	117%
Medica	$1,575 - $1,753	129%
Blue Cross Blue Shield	$1,853 - $3,172	152%
Total Care	$1,871 - $2,082	153%
Wellcare	$1,890 - $2,103	155%
Midlands Choice	$2,138 - $2,379	175%
Multiplan	$2,793 - $3,109	228%
Aetna	$4,038 - $4,495	330%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $2,710.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 45380.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Dundy County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 45380.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.